盐酸坦洛新联合清肾散瘀方治疗慢性前列腺炎的疗效及对患者免疫功能和尿流率的影响

Effect of tamsulosin hydrochloride combined with clear stasis and kidney decoction on chronic prostatitis and its influence on immune function and urine flow rate

目的 探讨盐酸坦洛新联合清肾散瘀方治疗慢性前列腺炎的疗效及对患者免疫功能和尿流率的影响.方法 选取慢性前列腺炎患者115例,并依据随机数字表法分为治疗组（58例）和对照组（57例）.对照组采用盐酸坦洛新治疗,治疗组在对照组的基础上加用清肾散瘀方治疗,两组均连续治疗4周.评价并比较两组患者的临床疗效以及免疫功能、自由尿流率及最大尿流率的变化.结果 治疗组总有效率为94.83%（55/58）,对照组总有效率为78.95%（45/57）,两组总有效率比较差异有统计学意义（P〈0.05）.治疗前两组患者IgA、IgG水平比较差异无统计学意义（P〉0.05）.治疗后两组IgA、IgG水平均明显降低,与本组治疗前比较差异有统计学意义（P〈0.05）,且治疗后治疗组IgA、IgG水平较同期对照组显著下降,差异有统计学意义（P〈0.05）.治疗前两组慢性前列腺炎症状评分（NIH-CPSI评分）和白细胞计数比较差异无统计学意义（P〉0.05）.治疗后两组NIH-CPSI评分和白细胞计数均显著下降,与本组治疗前比较差异有统计学意义（P〈0.01）,且治疗组较同期对照组显著降低,差异有统计学意义（P〈0.01）.治疗后治疗组卵磷脂小体（＋~＋＋）为3例,（＋＋＋~＋＋＋＋＋）为55例,对照组卵磷脂小体（＋~＋＋）为12例,（＋＋＋~＋＋＋＋＋）为45例,两组比较差异有统计学意义（χ2=6.392,P=0.011）.治疗前两组自由尿流率、最大尿流率、达到最大尿流率时间及残余尿量比较差异无统计学意义（P〉0.05）.治疗后两组自由尿流率、最大尿流率均较治疗前显著上升,达到最大尿流率时间较治疗前显著缩短,残余尿量较治疗前显著减少,差异有统计学意义（P〈0.05）,且治疗组治疗后上述指标与对照组比较差异有统计学意义（P〈0.01）.对照组不良反应发生率为3.51%（2/57）,治疗组为6.90%（4/58）,两组不良反应发生率比较差异无统计学意义（χ2=0.414,P=0.667）.结论 对慢性前列腺炎患者给予盐酸坦洛新联合清肾散瘀方治疗可明显缓解患者的临床症状,改善前列腺局部免疫功能,效果确切.

Objective To investigate the efficacy of tamsulosin hydrochloride combined with clear stasis and kidney decoction on chronic prostatitis and its influence on immune function and urine flow rate. Methods In this study, 115 patients with chronic prostatitis were selected and divided into treatment group （58 patients） and control group （57 patients） according to the random number table method.The control group used tamsulosin hydrochloride treatment, and the treatment group was treated with clear stasis and kidney decoction on the basis of the control group.The patients in two groups were treated continuously for 4 weeks. The clinical efficacy was evaluated and compared, the changes of immune function, free flow rate and maximum urinary flow rate were measured and compared between two groups.Results The total effective rate of the treatment group was significantly higher than that of the control group：94.83%（55/58）vs.78.95%（45/57）P〈0.05.The levels of IgA and IgG before treatment in two groups had no significant differences（P〉0.05）.After treatment, the levels of IgA and IgG in two groups significantly decreased compared with those before treatment（P〈0.05）, and the levels of IgA and IgG in treatment group were significantly lower than those in control group（P〈0.05）.The levels of NIH-CPSI scores and WBC before treatment in two groups had no significant differences （P 〉 0.05）. After treatment, The levels of NIH-CPSI scores and WBC significantly decreased compared with those before treatment（P〈0.01）, and the levels of NIH-CPSI scores and WBC in treatment group were significantly lower than those in control group （P 〈 0.01）. After treatment lecithin （＋- ＋＋） and （＋＋＋- ＋＋＋＋＋） in treatment group was 3,55 cases, in control group was 12,45 cases, and there was significant difference （χ2= 6.392, P = 0.011）. Before treatment, the levels of free urine flow rate, maximum urine flow rate, maximum urine flow rate time and residual urine volume in two groups had no significant differences（P〉0.05）. After treatment, the levels of free urine flow rate and maximum urine flow rate in two groups significantly increased, the levels of maximum urine flow rate time and residual urine volume in two groups significantly decreased, and there were significantly differences compared those before treatment （P 〈 0.05）.The levels of free urine flow rate, maximum urine flow rate, maximum urine flow rate time and residual urine volume between two groups had significant differences after treatment（P〈0.01）.The adverse reaction rate in control group and treatment group was 3.51%（2/57）,6.90%（4/58）, and there was no significant difference（χ2=0.414,P=0.667）.Conclusions Tamsulosin hydrochloride combined with clear stasis and kidney decoction in patients with chronic prostatitis can significantly relieve the clinical symptoms and improve the immune function of the local prostate, and the effect is exact.